Questions to Ask Before Becoming a Med Spa Medical Director
Published September 24, 2026 · 7 minute read · General information, not legal advice. Your licensing regulators decide what applies to you.
If you are a physician, NP, or PA, you may be approached by a practice owner who needs a medical director. The offer often comes with a monthly fee and a short description of the role: sign some protocols, be available by phone, and stop by once in a while.
Regulators can hold a supervising prescriber accountable for how services performed under their authority were delegated and supervised, even when they were not in the room. The questions below are the ones worth asking before you sign, and your own attorney and your carrier should read the agreement before you do.
Can you hold this role at all?
Whether your license type may serve as medical director, supervising physician, or collaborating prescriber for this practice, in this location, is the first thing to check. Your regulators decide it, and the answer can differ by license type and by service. Start with the regulator directory.
What is on the menu, now and planned?
Ask for the full service list, not the one on the website. Then ask what the owner plans to add in the next year. Energy devices, injectables, IV therapy, weight management, and peels each carry different questions. Overseeing a practice that offers injectables and IV therapy is a different commitment from overseeing one that will add RF microneedling and a laser in six months.
Who performs each service, and with what training?
For each service, ask who performs it, their license type, and what training they have had. Ask to see the training records rather than a summary. Ask whether anyone performs services their license may not cover where the practice operates. If the owner has not checked, you will be the one who has to.
What time does the owner expect, and what do the services require?
Owners sometimes budget the role at a few hours a month. The services themselves may need more: chart review, protocol updates, patient evaluations where your regulators require a prescriber to see the patient before treatment, availability during treatment hours, and response to complications. Work out what the menu needs and compare it to what is being offered. If the two do not match, raise it now.
Does your malpractice coverage extend to this?
Ask your carrier, in writing, whether your policy covers supervising these services and these staff at this practice. Many policies are written around your own clinical work. Ask whether your policy is claims-made or occurrence, and if it is claims-made, who pays for tail coverage when you leave. Ask whether the practice carries its own coverage and whether you are named on it.
Who owns the practice, and is that permitted?
Ask who owns the practice entity and how it is structured. In some places, ownership of a medical practice by non-prescribers is restricted or requires a specific structure. If the ownership is not permitted where the practice operates, your role in it may be a problem for you, not only for the owner. Take this to your attorney and your medical regulator.
What will be ordered under your name?
Ask whether any prescription products or devices will be ordered under your license, NPI, or DEA registration, and from which supplier accounts. Ask who places those orders, who receives them, and how you will see the invoices. Products bought on your credentials are your responsibility whether or not you placed the order.
How will your name be used?
Ask whether your name, credentials, or image will appear in the practice's marketing, and who signs off on that material. Claims made under your name can reach your regulator as easily as the practice's own. Agree in writing that nothing using your name goes out without your review.
Which protocols exist, and who wrote them?
Ask to see every written protocol. Ask who drafted each one and whether a prescriber has ever signed them. Protocols copied from another practice or supplied by a vendor need your review before your name goes on them. If there are no protocols, writing them is part of the job, and the time estimate should include it.
What will chart review look like?
Ask how charts are kept, whether you will have access to the record system, and how many encounters per month you would be reviewing. Decide the review method and frequency yourself, and put it in the agreement along with the log that should sit behind it.
Can you stop a service?
Ask whether the agreement gives you written authority to suspend a service, a device, a protocol, or an individual delegation immediately, without waiting for the owner. If you are accountable for a service and cannot stop it, you carry the risk without the control.
What happens after hours?
Ask what happens when a patient calls with a complication at night or on a weekend. Who takes the call, how you are reached, and who covers when you are unavailable. If nobody has planned for it, that is the first thing to settle.
How many sites?
Ask whether the practice operates at more than one location, runs mobile services, or plans to. Each site and setting can change what supervision means in practice and what your regulators expect.
Are devices in use, and who set the parameters?
If the practice runs energy devices, ask who set the treatment parameters and whether a prescriber has signed them. If a device representative set them, authorizing them becomes your job. Before you agree to that, read who may operate an energy device. If any service runs through a separate telehealth arrangement, read that contract's exclusions too.
How do you exit?
Ask what notice either party gives, what happens to patients and services during the notice period, who keeps the records, and how your signed protocols are retired when you leave. Ask whether you keep access to records after you leave, so you can respond to a claim or a regulator inquiry about care given under your authority. Check for non-compete or exclusivity terms that would limit other work. An agreement with no exit terms makes leaving harder at exactly the moment you may need to, and the practice will be working through its own side of the same event.
What to ask to see
Before signing, ask for the documents behind the answers: the current service list, the staff roster with license numbers, training records for each service, the existing protocols, a sample of recent charts with patient identifiers removed where that is appropriate, the device register if devices are in use, and the ownership structure. Ask for the draft agreement early enough to have your attorney and your carrier read it.
Keep copies of what you were given and note the date. If you later find that a service or a staff member was not disclosed, that record shows what you were told when you agreed.
Reading the answers
A practice that answers with documents is likely to run the same way once you sign. Vague answers about ownership, training, or device parameters are a reason to slow down. Declining, or agreeing only after specific changes are made, are both reasonable responses. Once you accept, the parts of the role are listed in what a medical director is accountable for.
The questions and records described here are in the Medical Director Engagement File.
This week
- Email your malpractice carrier and ask, in writing, whether your policy covers supervising this practice's services, and whether it is claims-made or occurrence.
- Ask the owner for the full service list, the staff roster with license numbers, and every written protocol.
- Look up your own regulator's position on whether your license type may hold the role, and save the page with the date.
- Send the draft agreement to your attorney with the suspension authority, tail coverage, and exit terms flagged.
Questions this guide answers
What are the responsibilities of a med spa medical director?
They depend on your jurisdiction and the agreement, but typically include authorizing protocols, delegating tasks, being available for supervision, reviewing charts, and responding to complications. Regulators can hold a supervising prescriber accountable for how services performed under their authority were delegated and supervised, even when they were not in the room.
Does my malpractice insurance cover being a medical director?
Not necessarily. Many policies are written for the prescriber's own clinical practice. Ask your carrier in writing whether the policy extends to supervising the specific services and staff of this practice.
Can a nurse practitioner be a medical director for a med spa?
Whether an NP or PA may hold that role, and under what conditions, is a question for your regulators. Verify it before discussing anything else.